Background Mast cells regulate the process of preeclampsia (PE). Since we previously identified mast cells specifically expressing miR‐181a‐5p in the placenta of PE patients, it is plausible to examine the effect and mechanism of mast cell‐derived exosomal miR‐181a‐5p on trophoblast cells. Methods The miR‐181a‐5p and YY1 levels were determined by quantitative real‐time reverse transcription‐polymerase chain reaction. Exosomes were identified by transmission electron microscopy, Western blot, and PKH‐26 labeling. Mast cells or trophoblast cell malignant phenotype were detected using 3‐(4,5‐dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2‐H‐tetrazolium bromide, wound healing, and Transwell assays. Quantification of YY1 and metastasis‐related proteins was performed using Western blot. TargetScan, JASPAR, dual‐luciferase reporter genes, and chromatin immunoprecipitation were exploited to verify the relationship between miR‐181a‐5p, YY1, and MMP‐9. Results MiR‐181a‐5p was overexpressed in mast cells of PE patients. Overexpressed miR‐181a‐5p restrained mast cell viability. Mast cell exosomes were successfully isolated, containing high expressions of CD63 and HSP70 and low expression of Calnexin and could be transported to the cytoplasm of trophoblast cells. Mast cell exosomes attenuated the viability, migration, and invasion of HTR‐8/SVneo cells, inhibited YY1, N‐cadherin, Vimentin, and MMP‐9 protein expressions, and promoted E‐cadherin protein expression. The effect of exosomes was enhanced by miR‐181a‐5p mimic but was reversed by miR‐181a‐5p inhibitor. MiR‐181a‐5p targeted YY1 which bound to the MMP‐9 promoter. Overexpressed YY1 in HTR‐8/SVneo cells accelerated the malignant phenotype of the cells and reversed the regulatory effects of exosomal miR‐181a‐5p. Conclusion Mast cell‐derived exosomal miR‐181a‐5p modulates HTR‐8/SVneo cell viability, migration, and invasion via YY1/MMP‐9.
Background: The rate of cesarean section (CS) is increasing worldwide (especially in China) reaching 51-65%. Although severe pelvic abscesses after CS are rare, they are difficult to treat. To address this problem, we herein report 23 cases of severe pelvic abscesses and their treatments. Methods: We identified 23 patients with severe pelvic abscesses using International Classification of Disease codes in a retrospective quality assurance analysis. Results and discussion: During the study, 23 women with severe pelvic abscess were identified among the 12640 patients who underwent cesarean delivery (CD). Eachpatient had a fever that lasted 5-17 days. B ultrasound or MRI revealed abscess cysts around the uterus in the pelvic abscess group. A total of 14 (60.9%) of the 23 patients with pelvic abscesses had wound dehiscence. In our patients, 15 patients had positive cultures, 10 were bacteria, two were Mycoplasma suis, and one was Rhizopus. Conclusions: In conclusion, our study reported that pelvic abscesses were always complicated with wound dehiscence and polycystic pus, and most of them were located anterior tothe uterus. Although we did not formulate a standard treatment for the pelvic abscesses, debridement was a good treatment option, and the patients’ temperatures were controlled after pus was expelled from their wounds.
Objective: This study aimed to investigate acute hemodynamics of lower extremities during enhanced external counterpulsation with a three-level sequence at the hips, thighs, and calves (EECP-3), two-level sequence at the hips and thighs (EECP-2), and single leg three-level sequence (EECP-1).Methods: Twenty healthy volunteers were recruited in this study to receive a 45-min EECP intervention. Blood flow spectrums in the anterior tibial artery, posterior tibial artery, and dorsalis pedis artery were imaged by Color Doppler ultrasound. Mean flow rate (FR), area, pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MV), and systolic maximum acceleration (CCAs) were sequentially measured and calculated at baseline during EECP-3, EECP-1, and EECP-2.Results: During EECP-3, PI, PSV, and MV in the anterior tibial artery were significantly higher, while EDV was markedly lower during EECP-1, EECP-2, and baseline (all P < 0.05). Additionally, ACCs were significantly elevated during EECP-3 compared with baseline. Moreover, FR in the anterior tibial artery was significantly increased during EECP-3 compared with baseline (P = 0.048). During EECP-2, PI and MV in the dorsalis pedis artery were significantly higher and lower than those at baseline, (both P < 0.05). In addition, FR was markedly reduced during EECP-2 compared with baseline (P = 0.028). During EECP-1, the area was significantly lower, while EDV was markedly higher in the posterior tibial artery than during EECP-1, EECP-2, and baseline (all P < 0.05). Meanwhile, FR of the posterior tibial artery was significantly reduced compared with baseline (P = 0.014).Conclusion: Enhanced external counterpulsation with three-level sequence (EECP-3), EECP-2, and EECP-1 induced different hemodynamic responses in the anterior tibial artery, dorsalis pedis artery, and posterior tibial artery, respectively. EECP-3 acutely improved the blood flow, blood flow velocity, and ACCs of the anterior tibial artery. In addition, EECP-1 and EECP-2 significantly increased the blood flow velocity and peripheral resistance of the inferior knee artery, whereas they markedly reduced blood flow in the posterior tibial artery.
Objective: Histological chorioamnionitis was associated with adverse outcomes. The objective of this study was to develop a prediction model for histological chorioamnionitis in preterm labor with intact membranes. Materials and Methods: Data were obtained from 307 women with singleton preterm labor (gestational age 28-33 +6 weeks) of the intact membranes between October 2011 and July 2014 in the Ningbo Women and Children's Hospital, Ningbo, China. Histological chorioamnionitis (HC) prediction model was developed with maternal independent risk factors before delivery. Results: Multivariable Logistic regression analysis showed that serum C-reactive protein (CRP) (OR=1.175, p = 0.0015, 95% confidence interval (CI) 1.064~1.297), and procalcitonin (PCT) (OR=9.736, p = 0.0117, 95% CI 1.658~57.166) were independent risk factors of HC. When PCT ≥ 0.05 ng/ml and CRP > 7.3 mg/L or PCT < 0.05 ng/ml and CRP > 21.4 mg/L, HC could be detected. HC was predicted with 91.1% accuracy, yielding an area under receiver operating characteristic (ROC) curve of 0.938 (95% CI 0.857~0.996), a positive predictive value of 84.6% (95% CI 65.1~95.6%), and a negative predictive value of 96.7% (95% CI 82.8~99.9%). Conclusion: Combined with CRP and PCT, HC could be predicted with high accuracy in preterm labor with intact membranes before delivery. Further studies should evaluate the value of this model to guide early treatment.
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